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In vitro activity of antimicrobial agents against extended-spectrum-beta-lactamase-producing enteric bacteria isolated from urine specimens

Poster (konferens)
Författare Sashka A Mihaylova
M Sredkova
V Edreva
S Pachkova
Nahid Karami
Edward R.B. Moore
Publicerad i FEMS 2009 - 3rd Congress of European Microbiologists
Sidor 136
Publiceringsår 2009
Publicerad vid Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 136
Språk en
Ämneskategorier Mikrobiologi inom det medicinska området

Sammanfattning

Objectives: To apply detailed phenotypic and genotypic analyses on extended-spectrum-beta-lactamase (ESBL)-producing clinical isolates. To determine in vitro activities of 14 antimicrobial agents and access these data with respect to treatment choice. Methods: One hundred strains were collected from urine samples of patients from Pleven University Hospital, Bulgaria, from January to December 2008. Patient ages: one month to 85 years. Two thirds were male. At the time of sampling, 50 patients were in Urology department, 23 were in Nephrology department, 8 were in Pediatric department, and 19 were in other departments. Double disc and Combination disc tests were applied for ESBL confirmation. ESBL-types were determined, using a multiplex PCR assay for CTX, TEX, SHV and OXA types. In vitro activities of fosfomycin, imipenem, meropenem, ertapenem, amoxicillin/clavulanic acid, piperacillin/tazobactam, gentamicin, amikacin, tigecycline, colistin, nalidixic acid, nitrofurantoin, ciprofloxacin and levofloxacin were determined by the disk diffusion method, according to guidelines of the CLSI. Results: All strains were confirmed to be members of the Enterobacteriaceae and to be ESBL producers. All strains were susceptible to the three carbapenems tested. Eighty-eight percent of the strains were susceptible to tigecycline, 74% were susceptible to amikacin, 64% were susceptible to piperacillin/tazobactam and 63% were susceptible to nitrofurantoin. More than 70% of the strains tested were resistant or intermediately susceptible to amoxicillin/clavulanic acid, gentamicin, nalidixic acid, ciprofloxacin and levofloxacin. Conclusions: Correlation was found between phenotypic and genotypic methods for detection of ESBL-producing bacteria. Carbapenems demonstrated excellent in vitro activity against strains of ESBL-positive enteric bacteria isolated in a Bulgarian university hospital. Tigecycline, amikacin, piperacillin/tazobactam, nitrofurantoin should also be considered as treatment options.

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